Disease center defends cheaper drugs for HIV

By Alison Hsiao / Staff reporter

The Centers for Disease Control (CDC) denied that there has been a drastic increase in the prevalence of HIV drug resistance among people with HIV, which the Taiwan AIDS Society president attributed to the CDC prescribing cheaper medication.

Society president Lin Hsi-hsun (林錫勳) called for the elimination of discrimination against people who are HIV positive at a press conference on Monday, saying that while the US guidelines for the initial combination regimens for antiretroviral therapy (ART) -naive HIV-infected patients, or HIV patients who have never received treatment, take their quality of life into consideration, Taiwan’s authorities see the cost of HIV drugs as the most important factor in their guidelines for treatment.

He referred to a regional study conducted by National Taiwan University Hospital that showed a doubling of the prevalence of HIV drug resistance from 8 percent last year to 16 percent this year.

“There are two possible causes,” Lin said. “One is the CDC’s recommended combination regimens, which were decided upon according to drug price, and this has resulted in our first-line therapy [provided for all ART-naive patients] being the less costly NNRTIs [Non-nucleoside reverse-transcriptase inhibitors], which is also more likely to induce drug resistance.”

“The other possible cause is unsafe sex without using condoms, which can transmit drug resistance virus,” he added.

The CDC later responded to the accusation by saying that a total of four classes of combination regimens have been provided as treatment guidelines.

While the CDC encourages use of the combination regimen that is less expensive, but equally effective, those with serious side-effects or other conditions that prevent the use of certain drugs can be prescribed with combinations that best suit their needs, it said.

The agency also said that the study referred to was regional in character and thereby limited, emphasizing that CDC’s national survey by random sampling recorded drug resistance prevalence of between 6.7 percent and 9.2 percent from 2009 to last year.

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